St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NCB SCREW X 4.0 SELF-TAP 44MM

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006950
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$233.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$133.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.93
Rate for Payer: EmblemHealth Commercial	$111.24
Rate for Payer: Fidelis Medicare Advantage	$233.60
Rate for Payer: Group Health Inc Commercial	$111.24
Rate for Payer: Group Health Inc Medicare	$77.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.61

NCB SCREW X 4.0 SELF-TAP 46MM

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006951
Hospital Revenue Code	278
Min. Negotiated Rate	$111.24
Max. Negotiated Rate	$111.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24

NCB SCREW X 4.0 SELF-TAP 46MM

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006951
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$233.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$133.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.93
Rate for Payer: EmblemHealth Commercial	$111.24
Rate for Payer: Fidelis Medicare Advantage	$233.60
Rate for Payer: Group Health Inc Commercial	$111.24
Rate for Payer: Group Health Inc Medicare	$77.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.61

NCB SCREW X 4.0 SELF-TAP 48MM

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006952
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$233.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$133.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.93
Rate for Payer: EmblemHealth Commercial	$111.24
Rate for Payer: Fidelis Medicare Advantage	$233.60
Rate for Payer: Group Health Inc Commercial	$111.24
Rate for Payer: Group Health Inc Medicare	$77.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.61

NCB SCREW X 4.0 SELF-TAP 48MM

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006952
Hospital Revenue Code	278
Min. Negotiated Rate	$111.24
Max. Negotiated Rate	$111.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24

NCB SCREW X 4.0 SELF-TAP 50MM

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006953
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$233.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$133.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.93
Rate for Payer: EmblemHealth Commercial	$111.24
Rate for Payer: Fidelis Medicare Advantage	$233.60
Rate for Payer: Group Health Inc Commercial	$111.24
Rate for Payer: Group Health Inc Medicare	$77.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.61

NCB SCREW X 4.0 SELF-TAP 50MM

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006953
Hospital Revenue Code	278
Min. Negotiated Rate	$111.24
Max. Negotiated Rate	$111.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24

NCB SCREW X 4.0 SELF-TAP 55MM

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006954
Hospital Revenue Code	278
Min. Negotiated Rate	$111.24
Max. Negotiated Rate	$111.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24

NCB SCREW X 4.0 SELF-TAP 55MM

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006954
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$233.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$133.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.93
Rate for Payer: EmblemHealth Commercial	$111.24
Rate for Payer: Fidelis Medicare Advantage	$233.60
Rate for Payer: Group Health Inc Commercial	$111.24
Rate for Payer: Group Health Inc Medicare	$77.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.61

NCB SCREW X 4.0 SELF-TAP 60MM

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006955
Hospital Revenue Code	278
Min. Negotiated Rate	$111.24
Max. Negotiated Rate	$111.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24

NCB SCREW X 4.0 SELF-TAP 60MM

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006955
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$233.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$133.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.93
Rate for Payer: EmblemHealth Commercial	$111.24
Rate for Payer: Fidelis Medicare Advantage	$233.60
Rate for Payer: Group Health Inc Commercial	$111.24
Rate for Payer: Group Health Inc Medicare	$77.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.61

NCB SCREW X 4.0 SELF-TAP 65MM

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006956
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$233.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$133.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.93
Rate for Payer: EmblemHealth Commercial	$111.24
Rate for Payer: Fidelis Medicare Advantage	$233.60
Rate for Payer: Group Health Inc Commercial	$111.24
Rate for Payer: Group Health Inc Medicare	$77.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.61

NCB SCREW X 4.0 SELF-TAP 65MM

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006956
Hospital Revenue Code	278
Min. Negotiated Rate	$111.24
Max. Negotiated Rate	$111.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24

NCB SPACER 1

Facility

$318.90

Hospital Charge Code	40006899
Hospital Revenue Code	272
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$255.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$159.45
Rate for Payer: Aetna Government	$159.45
Rate for Payer: Brighton Health Commercial	$239.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$255.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$216.85
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB SPACER 1MM

Facility

$139.44

Hospital Charge Code	40007082
Hospital Revenue Code	272
Min. Negotiated Rate	$48.80
Max. Negotiated Rate	$111.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$76.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.72
Rate for Payer: Aetna Government	$69.72
Rate for Payer: Brighton Health Commercial	$104.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$94.82
Rate for Payer: Group Health Inc Commercial	$69.72
Rate for Payer: Group Health Inc Medicare	$48.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$69.72
Rate for Payer: Hamaspik Choice Inc Medicare	$69.72

NCB SPACER 2

Facility

$318.90

Hospital Charge Code	40006900
Hospital Revenue Code	272
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$255.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$159.45
Rate for Payer: Aetna Government	$159.45
Rate for Payer: Brighton Health Commercial	$239.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$255.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$216.85
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB SPACER 2MM

Facility

$163.16

Hospital Charge Code	40007083
Hospital Revenue Code	272
Min. Negotiated Rate	$57.11
Max. Negotiated Rate	$130.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$81.58
Rate for Payer: Aetna Government	$81.58
Rate for Payer: Brighton Health Commercial	$122.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$130.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$110.95
Rate for Payer: Group Health Inc Commercial	$81.58
Rate for Payer: Group Health Inc Medicare	$57.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.58
Rate for Payer: Hamaspik Choice Inc Medicare	$81.58

NCB SPACER 3

Facility

$318.90

Hospital Charge Code	40006901
Hospital Revenue Code	272
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$255.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$159.45
Rate for Payer: Aetna Government	$159.45
Rate for Payer: Brighton Health Commercial	$239.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$255.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$216.85
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB SPACER 3MM

Facility

$178.00

Hospital Charge Code	40007084
Hospital Revenue Code	272
Min. Negotiated Rate	$62.30
Max. Negotiated Rate	$142.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$97.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$89.00
Rate for Payer: Aetna Government	$89.00
Rate for Payer: Brighton Health Commercial	$133.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$142.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$121.04
Rate for Payer: Group Health Inc Commercial	$89.00
Rate for Payer: Group Health Inc Medicare	$62.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.00
Rate for Payer: Hamaspik Choice Inc Medicare	$89.00

NCB STR NRW PLT 10H L146MM NONSTR

Facility

$1,238.48

Service Code	HCPCS C1713
Hospital Charge Code	40007284
Hospital Revenue Code	278
Min. Negotiated Rate	$619.24
Max. Negotiated Rate	$619.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$619.24
Rate for Payer: Hamaspik Choice Inc Medicare	$619.24

NCB STR NRW PLT 10H L146MM NONSTR

Facility

$1,238.48

Service Code	HCPCS C1713
Hospital Charge Code	40007284
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,300.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$681.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$743.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$619.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$712.13
Rate for Payer: EmblemHealth Commercial	$619.24
Rate for Payer: Fidelis Medicare Advantage	$1,300.40
Rate for Payer: Group Health Inc Commercial	$619.24
Rate for Payer: Group Health Inc Medicare	$433.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$619.24
Rate for Payer: Hamaspik Choice Inc Medicare	$619.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$805.01

NCB STR NRW PLT,10H,L 146MM STRL

Facility

$1,275.56

Service Code	HCPCS C1713
Hospital Charge Code	40007030
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,339.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$701.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$765.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$637.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$733.45
Rate for Payer: EmblemHealth Commercial	$637.78
Rate for Payer: Fidelis Medicare Advantage	$1,339.34
Rate for Payer: Group Health Inc Commercial	$637.78
Rate for Payer: Group Health Inc Medicare	$446.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$637.78
Rate for Payer: Hamaspik Choice Inc Medicare	$637.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$829.11

NCB STR NRW PLT,10H,L 146MM STRL

Facility

$1,275.56

Service Code	HCPCS C1713
Hospital Charge Code	40007030
Hospital Revenue Code	278
Min. Negotiated Rate	$637.78
Max. Negotiated Rate	$637.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$637.78
Rate for Payer: Hamaspik Choice Inc Medicare	$637.78

NCB STR NRW PLT 12H L174MM NONSTR

Facility

$1,238.48

Service Code	HCPCS C1713
Hospital Charge Code	40007285
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,300.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$681.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$743.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$619.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$712.13
Rate for Payer: EmblemHealth Commercial	$619.24
Rate for Payer: Fidelis Medicare Advantage	$1,300.40
Rate for Payer: Group Health Inc Commercial	$619.24
Rate for Payer: Group Health Inc Medicare	$433.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$619.24
Rate for Payer: Hamaspik Choice Inc Medicare	$619.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$805.01

NCB STR NRW PLT 12H L174MM NONSTR

Facility

$1,238.48

Service Code	HCPCS C1713
Hospital Charge Code	40007285
Hospital Revenue Code	278
Min. Negotiated Rate	$619.24
Max. Negotiated Rate	$619.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$619.24
Rate for Payer: Hamaspik Choice Inc Medicare	$619.24

Know your out-of-pocket cost for care.

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